Supplemental 2019 Questionnaire

2019 Novel Coronavirus Airport Entry Questionnaires

Documents and Forms

Document Name Document Type
Form 0920-20HF Supplemental 2019 Questionnaire Form and Instruction
0920-20HF Supplemental Questionnaire Attachment J Supplemental COVID-2019 Questionnaire3.2.2020-Final.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Supplemental 2019 Questionnaire	Agency IC Tracking Number:	0920-20HF

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-20HF	Supplemental Questionnaire	Attachment J Supplemental COVID-2019 Questionnaire3.2.2020-Final.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,333	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	5,333	-198,517	203,850
Annual IC Time Burden (Hours)	889	-33,086	33,975
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.